Keratosis pilaris is a disorder of keratinization in which horny plugs fill the openings of hair follicles.
Keratosis pilaris is common. The cause is unknown, but there is often an autosomal dominant inheritance.
Keratosis pilaris is associated with atopic dermatitis, seasonal allergic rhinitis, ichthyosis vulgaris, obesity, and diabetes mellitus type 1.
Multiple small, pointed, keratotic follicular papules appear mainly on the lateral aspects of the upper arms, thighs, and buttocks. Facial lesions may also occur, particularly in children. Lesions are most prominent in cold weather and sometimes abate in the summer. Skin may appear red.
The problem is mainly cosmetic, but the disorder may cause itching or, rarely, follicular pustules.
Treatment of Keratosis Pilaris
Symptomatic measures
Treatment of keratosis pilaris is usually unnecessary and often unsatisfactory.
Hydrophilic petrolatum and water (in equal parts) or petrolatum with 3% salicylic acid may help flatten the lesions. Buffered lactic acid (ammonium lactate) lotions or creams, urea creams, 6% salicylic acid gel, or 0.1% tretinoin cream or gel may also be effective. Other effective topical retinoids can include adapalene 0.1% cream or gel and tazarotene 0.05% cream or gel. Topical tacrolimus and azelaic acid in various strengths have also been shown to be effective. Acid creams should be avoided in young children because of burning and stinging.
Pulse-dye and Q-switched Nd:YAG 1064 nm lasers have been used successfully to treat facial redness.
